Rates of women who are opting for preventive mastectomies, such as Angeline Jolie, have increased by an estimated 50 percent in recent years, experts say. But many doctors are puzzled because the operation doesn't carry a 100 percent guarantee, it's major surgery -- and women have other options, from a once-a-day pill to careful monitoring.

At least eight states offer free mental health hot lines to help farmers and producers through difficult patches.

During times of exceptional drought, such as the one that has covered the country's southeast this year, the hot lines report a jump in calls from farmers needing emotional counseling and stress management.

The confidential hot lines offer a variety of resources such as vouchers for therapy sessions, referrals to mental health providers and trained financial experts who can analyze a farmer's bills. Some hot lines are operated by nonprofit or religious organizations while others, like Tennessee's, are a part of a university's agriculture department.

Agriwellness Inc., a nonprofit devoted to the behavioral health of people in agriculture, coordinates hot lines in Iowa, Kansas, Minnesota, Nebraska, North Dakota, South Dakota and Wisconsin and gets an average of 12,000 to 14,000 calls a year.

Michael R. Rosmann, the executive director of Agriwellness, said drought is especially tough on farmers and producers because its effects last over more than one season.

"It wears down people's spirits. You don't know when it's going to end and what you're going to do about it," Rosmann said.

Isolation worsens feelingsGeorgia Governor Sonny Perdue's decision to recently lead a state vigil praying for precipitation may have been derided, but Rosmann thinks the gesture brought immense comfort to many people.

Richard Jameson, a 53-year-old farmer in western Tennessee, watched his cotton and soybean crops shrivel under several weeks of extreme heat and a prolonged drought this year. He says it would have been harder to weather the crisis if he hadn't decided on his own to seek therapy about nine years ago.

"I was waking up at 4 a.m. every day with my heart pounding," Jameson said. "I had gotten to a point in my life when I knew I needed help."

Jameson says his regular visits to a therapist in Memphis, about 50 miles from his Haywood County farm, help him realize that he isn't alone in dealing with depression.

"Farmers often work by themselves. That near isolation can really exacerbate feelings of worthlessness, anxiety or depression," Jameson said. "We feel like nobody in the history of mankind has any idea what we go through."

Substance abuse, suicideRural farming families face several obstacles to getting mental and emotional help in times of crisis, says Kathy Bosch, extension specialist at the University of Nebraska-Lincoln. Bosch has studied Nebraska panhandle farmers and ranchers who are now in their eighth year of drought.

"There has been a stigma attached to asking for help," Bosch said. "Some of them were very leery or cautious to ask for help."

The University of Tennessee's hot line has reached an estimated 15,000 farm families since 1986.

"We can't solve all the problems, but we can help people think through a number of alternatives," said Clark Garland, a professor and coordinator of the hot line.

Untreated stress can push farmers into substance abuse, domestic abuse or suicide, according to Rosmann, who is also a clinical psychologist. About 2 percent of callers to the Agriwellness hot lines are people who are suicidal and rates of suicide are higher among rural males than their urban counterparts, he said.

"One of the things that helps is talking to other people and sharing feelings of uncertainty or disillusion. The verbal sharing of stress helps a lot," Rosmann said.

Jameson said he's not embarrassed to talk about his therapy with other Tennessee farmers and will encourage them to take advantage of the hot line as they prepare for next year's season.

"It's going to get colder, the nights are longer, all the bills are starting to come in. It's hard to be joyful and cheery when you're going through this," Jameson said.

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